Best Practice Guideline – DEGUM Recommendations on Breast Ultrasound

Abstract

For many years, breast ultrasound has been used in addition to mammography as an important method for clarifying breast findings. However, differences in the interpretation of findings continue to be problematic 1 2. These differences decrease the diagnostic accuracy of ultrasound after detection of a finding and complicate interdisciplinary communication and the comparison of scientific studies 3. In 1999, the American College of Radiology (ACR) created a working group (International Expert Working Group) that developed a classification system for ultrasound examinations based on the established BI-RADS classification of mammographic findings under consideration of literature data 4. Due to differences in content, the German Society for Ultrasound in Medicine (DEGUM) published its own BI-RADS-analogue criteria catalog in 2006 3. In addition to the persistence of differences in content, there is also an issue with formal licensing with the current 5th edition of the ACR BI-RADS catalog, even though the content is recognized by the DEGUM as another system for describing and documenting findings. The goal of the Best Practice Guideline of the Breast Ultrasound Working Group of the DEGUM is to provide colleagues specialized in senology with a current catalog of ultrasound criteria and assessment categories as well as best practice recommendations for the various ultrasound modalities.

Multiple foreign body granulomas after mastectomy with intraoperative application of tissue adhesive vs. surgical drainage – sonographic finding

“…All histologically proven granulomatous lesions in the TissuGlu group (n = 17) with or without residual adhesive material were described according to the best practice guidelines of DEGUM [12,13]. In conclusion, lesions are 4.4 to 18.3 mm in diameter, oval or irregular in shape (88.2 %), echogenic or isoechoic (97.1 %) with an ill-circumscribed marginal contour (73.5 %), posterior shadowing (94.1 %), and a horizontal axis (97.1 %).…”

Clinical Axillary Staging in Breast Cancer Patients Using Ultrasound Imaging

“…In order to increase reliability as well as teachability to achieve routine usability, we focused specifically on the cortical thickness of the lymph nodes, as some publications proved this parameter to be very promising and logical [9,11]. According to our own impression in daily medical education of residents, this parameter can be taught easier and more robustly documented than other criteria (e.g., lymph node shape, structure, and vascularization) [17].…”

Vaccine-associated axillary lymphadenopathy with a focus on COVID-19 vaccines

“…The metastatic involvement of a LN occurs from peripheral to central resulting in a corresponding change in the cortico-medullary structure. The criteria for suspicious axillary LNs are partial or complete thickening of the cortex > 3 mm, lobulated asymmetric configuration of the cortex, and loss of the cortico-medullary structure with a displaced fatty hilum or partial or complete loss of the fatty hilum [10,11]. Malignant LNs can have increased vascularization including peripheral and subcapsular portions (▶ Fig.…”

“…Der metastatische Befall eines LK erfolgt von peripher nach zentral, wodurch die Rinden-Mark-Struktur entsprechend verändert wird. Kriterien für suspekte axilläre LK sind eine teilweise oder vollständig verdickte Rinde > 3 mm, eine gelappte, asymmetrische Konfiguration der Rinde und eine Auflösung der Rinden-Mark-Struktur mit randlich verdrängtem, partiellem oder komplettem Verlust des Fetthilus [10,11]. Maligne LK können eine vermehrte Vaskularisation einschließlich peripherer und subkapsulärer Anteile aufweisen (▶ Abb.…”